Abstract: Psychosocial problems associated with cancer care are often unaddressed, particulariy related to lung cancer, which has been found to elevate risk for psychological distress relative to other cancers. Psychosocial problems can cause additional suffering, weaken adherence to prescribed treatments, and lead to increased lung cancer mortality^ independent of clinical factors. African American (AA) lung cancer patients may be particulariy vulnerable to psychosocial problems in cancer care due to a range of issues, including access to care and other bamers. In Phase 1 of this study we will utilize a nationally representative dataset from the Cancer Care Outcomes Research &Surveillance (CanCORS) Consortium to compare prevalence of depression symptoms, factors underiying depression symptoms, and rates of mental healthcare utilization in 2108 AA and NHW lung cancer patients. We will also examine effect of cancer care experiences on depression severity at 4-months post-diagnosis. This will be the first study to conduct these analyses using a population-based approach. Data is available from patients, physicians, and medical records, and thus we will be able to test for racial disparities, adjusting for relevant demographic, medical, institutional and social/ behavioral factors. We expect to confimn some of our assumptions and generate new questions about risks and protective factors that quantitative data cannot address. Therefore, Phase 2 will include in-depth qualitative assessments of beliefs about depression and mental healthcare seeking in AA and NHW lung cancer patients at Massachusetts General Hospital. This proposed pilot project represents an innovative effort to address racial disparities in mental healthcare services, which is an understudied aspect of cancer care. The team for this mixed methods study, led by Dr. Elyse Park of DF/HCC and Dr. Sheila Cannon of UMB are well-poised to conduct this study, which will contribute significantly to their career development. Both the Survey and Statistical Methods Core and Training Core will significantly contribute to this project.